Definition of Alzheimer’s disease:
- Form of dementia
- Neurological disease characterized by severe loss of mental ability
- Usually occurs at old age
- Fourth leading cause of death (after heart disease, cancer, stroke)
- 2 types:
o Familial: autosomal dominant
o Sporadic: unknown inheritance pattern.
Pathophysiology:
Amyloid is a natural body protein which functions normally until age 45 when it changes into B-amyloid, involving amyloid precursor protein (APP), which becomes pathological when it comes in contact with toxic metals. The pathologic B-amyloid causes the nerves of the brain of Alzheimer’s patients to have breaks or cross links called neurofibrillary tangles which form a senile plaque and cause these nerves to crunch up and get detached from each other, also causing the synapse to be destroyed consequently loss of brain impulse.(2)
Symptoms begin gradually.
- Include 7 stages
1- normal behavior
2- minor memory lapse (forgetting car keys)
3- confusion and loss of names (borderline stage which may not lead to AD)
4- mild Alzheimer’s: inability to think rationally
5- moderate Alzheimer’s: can’s remember names of close relatives
6- moderately severe Alzheimer’s: inability to dress and take care of personal needs
7- loss of speech and incontinence
8- death
Risk Factors
- advanced age
- reduced testosterone levels
- Apo E genotype
- Head injury
- Poor CVD health (diabetes, smoking, HTN, high cholesterol)
- Exposure to light metals (particularly Aluminum, which is found in higher quantities in AD patients)
Risk reducers:
- Intellectual stimulation
- Regular physical activity
- Social interaction
- Mediterranean diet (fruits, vegetables, low in SFA)
- B vitamins
- Omega 3 FA (DHA)
- Vitamin E + vit C
- Cholesterol lowering drugs
- Long term use of non-steroidal anti-inflammatory drugs
Treatment:
The disease is incurable, treatment includes several factors:
- Social treatment: nursing care, physical and emotional support, home modifications(safety and security)
- Pharmacological treatment
- Dietary treatment: because of poor nutrition
- Chelation Therapy: intravenous infusion of amino acids to pull toxic heavy metals from body and to pull atherosclerotic plaques off arterial walls
Reasons for Management Nutrition Therapy
- Patients are usually malnourished.
- There’s weight loss because of increased energy expenditure, eating is neglected.
- Weight loss increases risk of infection, skin ulcers, and decreases quality of life.
- Unable to recognize feelings of hunger, satiety, thirst.
- Dehydration might be a problem in some cases.
- Should avoid distraction during mealtimes.
Dietary factors which seem to affect progression of Alzheimer’s
- Essential fatty acids (especially omega 3, DHA)
- Vitamin E
- Thiamine (for improve mental function)
- Acetyl-L-Carnitine (slows progression)
